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Which of the following statements is true regarding management of an acute episode of MH?

a) Reconstitute dantrolene in normal saline and administer at 2.5 mg/kg intravenous over 5 minutes to maximum dose of 10 mg/kg

b) Active cooling is indicated if core body temperature is > 39 degrees Celsius with ice packs in axilla and groin, intravenous cold saline solution or cold saline lavage to a core temperature of 36 degrees Celsius

c) Correct metabolic acidosis with intravenous sodium bicarbonate 1-2 mEq/kg as needed

d) Discontinue inhalation anesthetic and hyperventilate the patient using the same anesthesia breathing system without any charcoal filter


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Answer

Answer c.

Any metabolic acidosis should be corrected with bicarbonate. Dantrolene should be reconstituted in sterile water and not normal saline. In case of hyperthermia (core temperature > 39 C) active cooling should be done to a core temperature of 38 C. Discontinue inhalation anesthetic and hyperventilate the patient with gas flow greater than 10 L/min of 100% oxygen. Place charcoal filter on inspiratory and expiratory limbs of the breathing circuit or replace the exposed elements of anesthesia breathing system or use a new non-rebreathing system.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.


See also MHAUS

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